Dataset Information

Neighborhood Violent Crime and Perceived Stress in Pregnancy.

ABSTRACT: Stress has been shown to adversely affect pregnancy outcomes. Neighborhood crime rates may serve as one publicly available social determinant of health for pregnancy studies that use registry or electronic health record datasets in which individual-level stress data are not available. We sought to determine whether neighborhood violent crime incidents were associated with measured perceived stress in a largely minority, urban pregnancy cohort. We performed a secondary analysis of the 1309 Philadelphia residents participating in the Motherhood and Microbiome cohort (n = 2000) with both neighborhood violent crime and Cohen's Perceived Stress Scale (PSS-14) data. Generalized linear mixed models accounting for confounding variables and geographic clustering demonstrated that, regardless of race, women with the highest quartile of neighborhood violent crime had significantly elevated odds of high stress compared to women with lower crime. We also found that Black women were more likely to have both the highest quartile of neighborhood violent crime and high stress than non-Black women. Overall, this study demonstrates that neighborhood violent crime is associated with perceived stress in pregnancy. Given disparate exposure to crime and prenatal stress by race, future work is warranted to determine whether urban neighborhood violence and/or stress reduction strategies would improve birth outcome racial disparities.

SUBMITTER: Shannon MM

PROVIDER: S-EPMC7432742 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Publications

Neighborhood Violent Crime and Perceived Stress in Pregnancy.

Shannon Megan M MM Clougherty Jane E JE McCarthy Clare C Elovitz Michal A MA Nguemeni Tiako Max Jordan MJ Melly Steven J SJ Burris Heather H HH

International journal of environmental research and public health 20200803 15

Stress has been shown to adversely affect pregnancy outcomes. Neighborhood crime rates may serve as one publicly available social determinant of health for pregnancy studies that use registry or electronic health record datasets in which individual-level stress data are not available. We sought to determine whether neighborhood violent crime incidents were associated with measured perceived stress in a largely minority, urban pregnancy cohort. We performed a secondary analysis of the 1309 Philad ...[more]

PMID: 32756321

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Project description:Background: Little is known about the link between perceived neighborhood walkability and prevalence of chronic disease. Even less is known regarding this association among Hispanic/Latino adults, despite exhibiting high rates of chronic diseases. Stress due to racial discrimination is a harmful social determinant of health in Hispanics/Latinos. Having both low perceived neighborhood walkability and high racial discrimination stress may exacerbate the chronic disease status of Hispanics/Latinos. Among a U.S. national sample of Hispanic/Latino adults, this cross-sectional study aims to examine (1) the associations among overall perceived neighborhood walkability, racial discrimination stress, and having a chronic health condition; and (2) whether overall perceived neighborhood walkability moderates the hypothesized association between racial discrimination stress and having a chronic health condition. Methods: In January 2018, 798 Hispanic/Latino adults (M age = 39.7 years, SD = 15.1; 58.6% female; 70.0% U.S. born; 52.0% Mexican/Mexican American) responded to a survey via Qualtrics Panels. Surveys included the Neighborhood Environment Walkability Scale-Abbreviated, Hispanic Stress Inventory-2, and self-reported presence/absence of chronic health conditions (e.g., hypertension, heart disease). A logistic regression was conducted testing for the moderation of the main effect of racial discrimination stress on the presence of a chronic health condition by overall perceived neighborhood walkability. Results: After controlling for age, body mass index, and income, racial discrimination stress was inversely associated with overall perceived neighborhood walkability (b = -0.18, p < 0.001) and positively associated with having a chronic health condition (OR = 1.02; 95% CI [1.00, 1.03]). While overall perceived neighborhood walkability was not associated with having a chronic health condition, perceived crime safety was inversely associated with having a chronic health condition (OR = 0.94; 95% CI [0.89, 0.99]). Perceived crime safety moderated the positive association between discrimination stress and having a chronic health condition, such that the association was only significant among those who perceived their neighborhood to be less safe (? = -0.004, 95% CI [-0.01, -0.00]). Conclusions: Overall perceived neighborhood walkability was inversely associated with racial discrimination stress, but not associated with having a chronic health condition. Perceived neighborhood crime safety, but not infrastructure or aesthetics, matters when it comes to the link between racial discrimination stress and having a chronic health condition among Hispanics/Latinos.

Project description:BackgroundAntipsychotics and mood stabilisers are prescribed widely to patients with psychiatric disorders worldwide. Despite clear evidence for their efficacy in relapse prevention and symptom relief, their effect on some adverse outcomes, including the perpetration of violent crime, is unclear. We aimed to establish the effect of antipsychotics and mood stabilisers on the rate of violent crime committed by patients with psychiatric disorders in Sweden.MethodsWe used linked Swedish national registers to study 82,647 patients who were prescribed antipsychotics or mood stabilisers, their psychiatric diagnoses, and subsequent criminal convictions in 2006-09. We did within-individual analyses to compare the rate of violent criminality during the time that patients were prescribed these medications versus the rate for the same patients while they were not receiving the drugs to adjust for all confounders that remained constant within each participant during follow-up. The primary outcome was the occurrence of violent crime, according to Sweden's national crime register.FindingsIn 2006-09, 40,937 men in Sweden were prescribed antipsychotics or mood stabilisers, of whom 2657 (6·5%) were convicted of a violent crime during the study period. In the same period, 41,710 women were prescribed these drugs, of whom 604 (1·4 %) had convictions for violent crime. Compared with periods when participants were not on medication, violent crime fell by 45% in patients receiving antipsychotics (hazard ratio [HR] 0·55, 95% CI 0·47-0·64) and by 24% in patients prescribed mood stabilisers (0·76, 0·62-0·93). However, we identified potentially important differences by diagnosis-mood stabilisers were associated with a reduced rate of violent crime only in patients with bipolar disorder. The rate of violence reduction for antipsychotics remained between 22% and 29% in sensitivity analyses that used different outcomes (any crime, drug-related crime, less severe crime, and violent arrest), and was stronger in patients who were prescribed higher drug doses than in those prescribed low doses. Notable reductions in violent crime were also recorded for depot medication (HR adjusted for concomitant oral medications 0·60, 95% CI 0·39-0·92).InterpretationIn addition to relapse prevention and psychiatric symptom relief, the benefits of antipsychotics and mood stabilisers might also include reductions in the rates of violent crime. The potential effects of these drugs on violence and crime should be taken into account when treatment options for patients with psychiatric disorders are being considered.FundingThe Wellcome Trust, the Swedish Prison and Probation Service, the Swedish Research Council, and the Swedish Research Council for Health, Working Life and Welfare.

Project description:BackgroundAlthough selective serotonin reuptake inhibitors (SSRIs) are widely prescribed, associations with violence are uncertain.Methods and findingsFrom Swedish national registers we extracted information on 856,493 individuals who were prescribed SSRIs, and subsequent violent crimes during 2006 through 2009. We used stratified Cox regression analyses to compare the rate of violent crime while individuals were prescribed these medications with the rate in the same individuals while not receiving medication. Adjustments were made for other psychotropic medications. Information on all medications was extracted from the Swedish Prescribed Drug Register, with complete national data on all dispensed medications. Information on violent crime convictions was extracted from the Swedish national crime register. Using within-individual models, there was an overall association between SSRIs and violent crime convictions (hazard ratio [HR] = 1.19, 95% CI 1.08-1.32, p < 0.001, absolute risk = 1.0%). With age stratification, there was a significant association between SSRIs and violent crime convictions for individuals aged 15 to 24 y (HR = 1.43, 95% CI 1.19-1.73, p < 0.001, absolute risk = 3.0%). However, there were no significant associations in those aged 25-34 y (HR = 1.20, 95% CI 0.95-1.52, p = 0.125, absolute risk = 1.6%), in those aged 35-44 y (HR = 1.06, 95% CI 0.83-1.35, p = 0.666, absolute risk = 1.2%), or in those aged 45 y or older (HR = 1.07, 95% CI 0.84-1.35, p = 0.594, absolute risk = 0.3%). Associations in those aged 15 to 24 y were also found for violent crime arrests with preliminary investigations (HR = 1.28, 95% CI 1.16-1.41, p < 0.001), non-violent crime convictions (HR = 1.22, 95% CI 1.10-1.34, p < 0.001), non-violent crime arrests (HR = 1.13, 95% CI 1.07-1.20, p < 0.001), non-fatal injuries from accidents (HR = 1.29, 95% CI 1.22-1.36, p < 0.001), and emergency inpatient or outpatient treatment for alcohol intoxication or misuse (HR = 1.98, 95% CI 1.76-2.21, p < 0.001). With age and sex stratification, there was a significant association between SSRIs and violent crime convictions for males aged 15 to 24 y (HR = 1.40, 95% CI 1.13-1.73, p = 0.002) and females aged 15 to 24 y (HR = 1.75, 95% CI 1.08-2.84, p = 0.023). However, there were no significant associations in those aged 25 y or older. One important limitation is that we were unable to fully account for time-varying factors.ConclusionsThe association between SSRIs and violent crime convictions and violent crime arrests varied by age group. The increased risk we found in young people needs validation in other studies.

Dataset Information

Neighborhood Violent Crime and Perceived Stress in Pregnancy.

Publications

Neighborhood Violent Crime and Perceived Stress in Pregnancy.

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